Recommended Resources

I oftentimes get asked what resources I recommend. The resources listed below have been essential at putting me down the path that I am currently going, and have shaped how I practice today.

Trips = reading opportunities.

The cool thing about this list? None of these are set in stone. If I find a better resource, or one of the blogs I recommend starts to resonate with me less, it leaves the list (no pressure).

I want to give you guys the most up-to-date resources as humanly possible, so please check back here frequently.

If you’d like articles and such that are tripping my trigger as of late, you may want to sign up for my newsletter. You’ll also get some access to almost 3 hours and 40+ pages worth of exclusive content on pain and breathing.

Here are my resources:

Foundational Sciences

Video series

Makemegenius – A youtube page dedicated to explaining scientific concepts that a kid could understand.

Crashcourse – Another series of short videos explaining complex scientific topics and more in 15 minutes or less. I wish I had this in undergrad.

Books

Gilroy Atlas of Anatomy – Easily the best paper anatomy atlas you can find in the land. The angles drawn, the clarity of pictures, this atlas has it all. Wait until you see the subocciptals from the side. #mindblown

Guyton and Hall Textbook of Medical Physiology – Easily the best and most comprehensive physiology textbook in the land, the depth at which this book dives into with concepts is otherworldly. If I need clarification on a physiological process, this is my go-to.

Physiology of Training for High Performance – Easily the best exercise physiology textbook I’ve come across. Very few explain the energy systems with such depth, and I absolutely love the sections on the stretch shortening cycel

Kinesiology of the Musculoskeletal System – Neumann is the gold standard for explaining how each joint works in the human body. There is simply no more of a comprehensive resource on movement than this book.

The Physiology of Joints Volumes 1, 2, & 3 – If you want a more thorough understanding of joint structure and function, look no further. Just good luck finding copies that won’t cost you an arm and a leg.

Why Zebras Don’t Get Ulcers – The classic written by the master himself, Robert Sapolsky. This is the gold standard text on all things stress. His writing style makes a normally boring topic exciting to read.

Principles of Neural Science – Prepare to have your mind blown. The depth at which the neurology goes within this book is incredibly challenging, but if you need to reference something neuro-related, this is the book to have.

Apps & Technology

Visible Body Atlas – The gold standard 3D anatomy atlas. The visuals are stunning, and it is incredible to see how the anatomy looks from multiple angles.

Visible Body Muscle Premium – Yes, you need this too. Seeing how muscle contract to move the bones is worth the price of admission.

Rehabilitation

Blogs & Podcasts

Bill Hartman – Daddy-O Pops Bill Hartman is the cat who I look up to the most, not just in the PT realm, but in life. His blog consists of neat little tips to improve multiple aspects of your life, and he is the go-to-guy when thinking about developing your system or model. I appreciate his systematic approach.

Resilient Peformance Physical Therapy – My boys, Doug Kechijian, Trevor Rappa, and Greg Spatz, put out a lot of great content. These guys do such a great job of putting problems of the profession into perspective, and looking at things with as little bias as possible.

Doug also host a wonderful, eclectic podcast, where he interviews many people within and outside the profression, drawing comparisons to things we experience in performance and rehab.

Mike Reinold – Mike is who I look to for all things post-surgical, pathology, and PT research. I admire his breadth of knowledge base in these areas, and his Ask Mike Reinold show is full of great pearls.

Charlie Weingroff – Charlie is one of those cats who does a good job bridging the gap between rehabilitation and performance. Though I know we practice differently, I find myself nodding my head a lot when he discusses systems and principles. I appreciate his ability to integrate multiple thought processes into his own approach.

Modern Manual Therapy Blog – If I want to learn about manual therapy, TMJ, and more, Erson is my guy. I took his course many moons ago, and admire how well he assimilates multiple systems into his own approach.

Seth Oberst – I love how Seth integrates meditation, interaction, threat reduction, and many other aspects into his approach. When it comes to stress mitigation, Seth is the guy.

Scott Gray – Scott is a PT I admire when it comes to evaluation, testing, and diagnosing conditions, definitely not my strongest suit of things.

Healthy Wealthy & Smart – A podcast put on by a physical therapists named Karen Litzy, Karen goes around interviewing physical therapists from all walks of life. I’m always getting an inspiration to study something further or a pearl of clinical application every time I listen to her interviews. Her advocacy for the physical therapy profession is admirable.

The Ca$h Based Practice Podcast – Jarod Carter was the early pioneer regarding building a cash based practice. Business was never my strong suit, so getting access to the information in this podcast has been clutch.

PT Adventures – How do I learn about contract negotion? What do I look for in a recruiter? OMG where was that picture taken?!?! These guys know all the ins and outs when it comes to travel PT, and are by far the foremost experts on the topic. Their complementary E-book is an absolute must, even if you aren’t considering travel.

Apps & Technology

A Manual of Acupuncture – I was taught dry needling through somewhat of a medical acupuncture lens, and if you dive into the literature you’ll need to know the acupuncture points. I would be lost if it weren’t for this app.

Recognise Apps – Essential for graded motor imagery retraining. This app not only has graded left/right discrimination challenges, but also tracks accuracy and timing. The best on the market, and has all body parts available.

Books

Diagnosing & Assessment

Differential Diagnosis for Physical Therapists – Do no harm is priority number one. This book is your guide that ensures you keep people in your clinic who you can help, and refer those who you can’t.

Primary Care for the Physical Therapist – If we push the physical therapy profession to first line providers, this text will become more and more essential. This book teaches you the things you need to know to become a primary care provider.

Orthopedic Rehabilitation Clinical Advisor – When it comes to specific orthopedic diagnoses, this is by far the most user friendly. This book gives you ideas in terms of differential diagnosis, testing, prognosis, and so much more.

Netter’s Orthopedic Clinical Examination – Want to know which tests are most accurate and effective? This text is the one for you then. Love how they look at multiple different assessment pieces, and use evidence to either support or refute their utility.

The Malalignment Syndrome – Want to understand and appreciate asymmetry in the human body? Then this is the resource for you. This book shows many of the common restrictions seen in our movement assessment, and explains from an osteopathic standpoint what is going on.

Pain & Nervous System

Why Do I Hurt – The essential book for understanding basic pain neurobiology in the easiest way.  I absolutely love Adriaan Louw’s analogies and examples for explaining pain to patients. It’s a quick read well worth the time.

Therapeutic Neuroscience Education: Teaching Patients About Pain – In the explosion of pain science books, this one is by far the most practical. Here Adriaan Louw simply explains how pain works, and provides excellent strategies for educating patients with easy-to-understand language.

The Sensitive Nervous System – This is the heavy version of understanding how this whole nervous system and pain works. David Butler discusses the nervous system, central sensitization, neurodynamics, and so much more. Fantastic read.  [read the book notes here]

Clinical Neurodynamics – Michael Shacklock looks at the concepts of neural mobility through a more anatomical and physiological lens, and taught me how to appreciate the neural container (the tissues surrounding the nerve).  [read the book notes here]

Topical Issues in Pain Volume 1 – Louis Gifford is all about not getting too sciency and more about practically applying this pain science stuff. His early work is essential reading.

Treatment

Recognizing and Treating Breathing Disorders – If you want to know all the essentials in applying breathing to treatment, this is the gold standard. Anytime I go to review physiology of breathing, this is my go-to text. [read some of the book notes here]

Region-Specific

The Pelvic Girdle – Diane Lee provides the go-to resource for learning all things about the pelvis. The first half of the book is gold—anatomy, kinesiology, etc. The treatment half? Well, it’s not what I would do, but whatever 🙂

Orofacial Pain – This book is incredibly dense, and surprisingly one of the best pain science texts around. But if you want to learn the ins and outs of orofacial pain, it’s a must.

Hand and Wrist Rehabilitation: Theoretical Aspects and Practical Consequences – To go-to for all things hand and wrist. The graphic showing wrist kinematics are like nothing I’ve ever seen, and worth the price of admission.

Courses

Spinal Manipulation Institute – These guys are the go-to for learning dry needling. I’ve also taken their extremity manipulation class, which was nicely done as well. The consistent theme with all of their coursework is evidence. They do a great job outlining what the research says, and even what it doesn’t say. I appreciate them attempting to minimize their biases.

Active Release Technique – I only took these because I was able to go on someone else’s dime, and I was pleasantly surprised. The preparation and execution of the class greatly improved my understanding of anatomy and movement. The technique and concept itself is simple, yet quite effective. Especially considering the short amount of time it takes. It’s a great soft tissue technique, though pricier than necessary.

Johnny Owens Bloodflow Restriction Training – I thought this was a gimmick at first, then my boy Johnny Owens dropped research bombs on me left and right. I was amazed at how effective this was, and I’ve personally seen some nice changes both in myself and clients with utilizing BFR. Johnny hosts the gold standard class.

Postural Restoration Institute – A good way to get you started thinking about the movement system as a whole, and seeing how exercise selection can impact multiple areas. I typically recommend the following class order: Myokinematic RestorationPostural Respiration → Pelvis Restoration → Impingement and Instability. I would cap it at that. I’ve found if you have a good understanding of these courses, and enrich your understanding with similar sources, you’ll rarely if ever need to explore the more esoteric routes.

Dermoneuromodulation – ART is a bit more aggressive of a manual technique, DNM is much much lighter and quite effective. Diane also has the best explanation on manual therapy mechanisms I have ever come across, and that is worth the price admission alone.

Explain Pain – When I took this class by David Butler, I was absolutely blown away. Easily one of the best classes for understanding pain mechanisms, and some of most helpful metaphors you will find for education.

Therapeutic Neuroscience Education – Whereas Explain Pain is more science-heavy, Adriaan Louw’s iteration is all about practical application. He has some of the simplest and most effective ways to explain how pain works to clients. A must take.

A Study of Neurodynamics: The Body’s Living Alarm – While I haven’t taken this class formally, Adriaan’s version of Mobilisation of the Nervous System had way more practical applications that other iterations of the class I’ve taken. When it comes to neurodynamics, you need treatment ideas. Adriaan is the guy who I got that from the most.

Graded Motor Imagery – What do you do when all movements hurt? That’s where GMI comes into play. This class takes you through introducing someone into movement by teaching left/right discrimination, visualization, and mirror therapy. I use this quite a bit in early phases of rehab; especially if someone is not allowed to move the affected area.

Performance

Blogs & Podcasts

Mike Robertson – Mike was one of the first dudes that got me inspired to dive into this field. He has some of the most in-depth coaching posts like ever. Period. We also think very similarly from a coaching standpoint. Head to his site if you want to learn how to design a comprehensive strength training program for general population to athletes alike.

Mike also hosts one of the best podcasts in performance, in which he interviews a bunch of people in the fitness industry, including this joker. 

Eric Cressey – Been a big fan of Eric for a very long time. His book, Maximum Strength, was one of the first training programs I used that led to appreciable gains in strength. His knowledge of the upper extremity and shoulder is unparalleled, and that includes the rehabilitation

Darkside Strength – This is a good compilation site for a wide variety of performance topics. Ranging from med ball throws, to thorax rotation, to posture, you’ll find just about anything you’d like to learn about on this site.

YLM Sports Science – Yann Le Meur is awesome. What he does is takes important research articles, and disseminates them into useful infographics. If you want to get a quick summary of relevant research articles, here’s the site.

Joel Jamieson – Joel is the foremost expert on all things conditioning. I love how he integrates sports science (namely heart rate variability) and many other measures to make logical programming decisions.

Lance Goyke – Lance is one of my dear friends who writes on a wide variety of topics; ranging from building mass, to how overrated stretching is, to excellent physiology lessons. I love his 4 point Friday that he sends to his newsletter peeps, as he exposes you to very cool reads and listens on a wide variety of topics.

TD Athletes Edge – The place my boy Tim Difrancesco built. Here, Tim discusses all factors that are relevant to performance, such as diet, sleep, stress management, and movement. I really like the stuff Tim puts out because we have very aligning philosophies.

Tony Gentilcore – Tony is a guy who I refer to quite a bit regarding coaching cues and the like. Cat has one of the prettiest deadlifts in the game, so have to throw mad respek his way.

Dean Somerset – Dean is my go-to guy for post-rehab training. Love how he incorporates a wide variety of things into his training, and he always writes posts that make me think.

Bret Contreras – I admire how much Bret is a steward of the science and all things evidence-based. He’s also the guy who pioneered the hip thrust exercise. While not something I incorporate much in my training, definitely a great move if gluteal hypertrophy is your goal.

Chaos & Pain (NSFW, or most anyone) – With many of us emphasizing recovery, high/low methods, and not going too hard, sometimes you need a swift kick in the teeth and someone to tell you to get after it. That’s why I go to Jamie Lewis. The guy is also an encyclopedia when it comes to old time strength people and cooking stew. Definitely an underrated site.

Apps & Technology

Polar Beat – If you play with heart rate training, this app is a must. Here it’ll track your heart rate, time spent exercising, and so much more.

Tabata Pro – My favorite app for interval training. Simple, easy to use, and effective in both visual and auditory cues for when to go!

Books

All Gain, No Pain – Yeah, I’m a little biased (I did write the foreword after all), but Bill Hartman’s first book is an instant classic. I love how all-encompassing this book is. You’ll get an understanding of pain, stress, performance. But most importantly, you’ll be able to design a program that is specifically built for you. If you are post-rehab and looking for a way to get back into training, this book is a must.

Ultimate MMA Conditioning – Aka energy systems and application made ridiculously simple. Joel Jamieson’s classic book teaches you most of what you need to know when designing effective conditioning programs. It’s an essential read.

Starting Strength – If you want to enhance your understanding of the mechanics of basic lifts, this book is essential. My favorite section is the squat chapter.

New Functional Training for Sports – Mike Boyle has some of the best progressions that are simple and easy to execute. I like this book a lot because it is all practical application. His jump progression makes up a bulk of how I introduce the concept of jumping to my clients.

Essentials of Strength and Conditioning – Yeah, the exercise and nutrition sections are lackluster, but you’d be hard pressed to find a better overview of all things S&C. Some of the basic science chapters are easy to understand, which is incredibly valuable to me.

Spark – This book will make you rethink just how powerful aerobic exercise is.

Courses

Resilient Movement Foundations – An essential class to attend if you want to master the basic movements. I also like how if a movement cannot be performed, the boys at Resilient give you methods to assist in performance.  If you want an overview, check out my course notes.

FMS Level 2 – While I’m not an avid FMS/SFMA practitioner, I thoroughly enjoy their intelligent exercise progressions and coaching styles. Some of the variants taught at the level 2 in particular are things I readily incorporate into my practice.

Derek Hansen – One of the best sprinting coaches I’ve ever come across. His seminar that I attended was all about practice application, and his simple coaching cues to improve sprinting have made a huge impact in my clientele. Want to learn sprinting? Here’s the guy.

Tim Gabbett – The acute:chronic workload is a fundamental principle that we must all consider in both the rehabilitation and performance realms. No one teaches it better from an application standpoint than Tim Gabbett.

ALTIS Apprentice Coach Program – How does getting to learn from the likes of world class track coaches Dan Pfaff and Stu McGill for a week sound? One of the best investments I’ve ever made, you learn basically what you want to learn from this apprenticeship program. The biggest takeaways I got involved the art of coaching, resiliency training, plyometric programming, and that’s just a small taste.

Certified Speed and Agility Coach – Lee Taft is the foremost expert when it comes to multidirectional training. This online cert provides a great overview of all the skills one must possess when playing a multidirectional sport.

Nutrition, Functional Medicine, Sleep, & Wellness

Blogs & Podcasts

Mike Roussell – Mike is one of my favorite nutrition peeps in the land. Responsible for the great book the Metashred Diet, a diet I used to drop my first 20 pounds, Mike is all about practical application in regards to dieting. His steps are simple, easy to use, and require easy changes in behavior. Definitely a guy to learn from.

Chris Kresser – Chris hosts one of the most comprehensive functional medicine combined with ancestral diet resources I have ever seen. Many of the things he has posted on my site have helped me a great deal with some of the health issues I have experienced, and his practioner program is very intriguing to me. You will not be disappointed by what he has to say.

The Paleo Solution Podcast – Hosted by Paleo extraordinaire Robb Wolf, I amazed at how well versed he is in the wide variety of topics discussed in this podcast. Whether he’s interviewing a sleep expert, paleo enthusiast, or

Rhonda Patrick – RP (#bae) has gotten me so much into genetics, fasting, sauna use, and many other topics.  The papers she puts out for her newsletter peeps are beyond comprehensive. Definitely check out her site, listen to her podcast, and consume as much as possible.

Peter Attia – This blog is technically retired, but Dr. Peter Attia is a wealth of information when it comes to all things functional medicine. I admire his approach and emphasis on blood sugar management, hormones, and many more things. If I were ever to go to medical school, I’d want to turn out like this guy did.

Apps & Technology

Zero – This is the go-to app to use if you are experimenting with fasting. It times how long you’ve gone without eating, and keep you on target with the desired duration you wish to fast.

The Oura Ring – By far my favorite tracking device, and I’ve experimented with the best of them. The Oura ring is by far the most accurate sleep tracker you can buy. It also measures HRV, body temperature, activity levels, and the newer model do things for finding your circadian rhythm. All within a sleek looking ring. You’d be amazed at what you can learn from wearing this ring, especially in terms of what late night behaviors can impact sleep.

BrainWave – The best white noise app in the land. Also combines calming sounds with various waves that supposedly stimulate various brain states. Does it work? Who knows, but I’ll hedge my bets.

F.lux – An app that blocks blue light, the stuff that keeps you awake at night, on your screens. Essential for anyone who has to work on their computer late.

Books

The Metashred Diet – Just do it. That could be the mantra for this great read by Mike Roussell. Here, he just lays out a plan of attack to execute an all-out war on fat loss, and it is quite effective. I was able to drop close to 20 pounds staying militant on the 56 day plan, and I’ve kept up with many of the principles on a consistent basis.

Sleep Smarter – A little bit heavier on the esoteric sleep strategies, but I was blown away by how effective implementing these strategies have been. The biggest takeaway for me from this book was the importance of light exposure. A great read.

Take a Nap! Change Your Life – Who knew effective napping could be so scientific? If you want to get the most out of your naps, or question just how important napping is, let this be the answer.

Sleep for Success! Everything you Must Know About Sleep but are Too Tired to Ask – This book provides a little bit of background knowledge regarding sleep, and some easy strategies to implement to enhance your sleep quality. It’s a little salesman-heavy at times, but still a solid read nonetheless.

Courses

Precision Nutrition Level 1 – An excellent combination of overview, depth, and application of nutritional coaching. The emphasis on behavior change is critical, and I admire how that makes up the backbone of this great certification.

Personal Development & Entrepreneurship

Blogs & Podcasts

Barking up the Wrong Tree – Probably my favorite blog on the internet. Like…for real. Why are you still here??? Eric Barker is a guy who researches many different topics, and breaks down the information into 3-5 applicable points. My favorite? How to be James Bond of course!

The Tim Ferriss Show – One of the most popular bloggers of all time, Tim goes around interviewing a wide variety of people, seeking answers on how to get the most out of life in the fastest manner possible.  He also has great q&a’s and talks on building business and more. An essential listen.

Jocko Podcast – The podcast of former Navy Seal Jocko Willink. My favorite podcasts are his Q&As, where he problem solves listener questions with incredibly practical advice that you probably don’t want to hear, but need to hear. Definitely a life changing person to learn from.

Seth Godin – He writes a short blog every day that will either inspire you, make you rethink what you are doing, or be just the thing you need to hear.

I Will Teach You to Be Rich – Ramit Sethi promotes a message that really resonates with me. He writes profoundly on topics ranging from personal finance, entrepreneurship, and marketing. Definitely check this cat out.

Books

Extreme Ownership – One of the most impactful books I have ever read in my life. Consider it the practical guide for controlling the things that you can control. You’ll be amazed at what making this shift in mindset can do for you.

The Obstacle is the Way – I read this book during a rough patch in life, and it helped me appreciate how impactful adversity can become. It can break us or shape us. Use those hard things in life as opportunities to grow. This will help you along the way.

The Ego is the Enemy – Something I’ve struggled with through much of my life is squashing ego. This book was essential for doing that. Realize that you aren’t that important, keep a beginner’s mindset, and be humble. Understanding these three concepts will get you far in life.

The Subtle Art of not Giving a F*ck – After you’ve squashed your ego, read this bad boy to bring it up to appropriate levels. This book is essential in helping you understand just how frivolous most things in life are. I sweat so many fewer things thanks to this phenomenal read.

The Millionaire Fastlane – This book will forever change how you think about running your business, running your life, and why it is important to strive for a business that makes you millions. It’s more of a selfless reason than you think.

Unscripted – Another great in-your-face book by MJ DeMarco. This one makes you really think about striving for that 40 hour work week until your dead. Another life changing book.

The 4-Hour Work Week – Elimination, automation, and many more outstanding principles occur in this book. The biggest key I got from this was a guide on streamlining many of the processes I have in place from a business standpoint. It’ll definitely make you think about how you are currently running your life.

Discipline Equals Freedom Field Manual – On those days you lack motivation, or when you feel like blaming others for problems, or are experiencing tough times, just read one page. Never did a book exist that helped me refocus as well as this one.

The Definitive Book of Body Language – Nonverbal communication is essential to effectively communicating with a wide variety of people. You will be amazed at some of the relative nonverbal “mistakes” we make when interacting with others. Mastering this book will enhance your relatability to a high degree.

How to Talk to Anyone – Another great key read in maximizing verbal and nonverbal strategies to  become an effective communicator. One of my favorite tips? Taffy eyes. Get it to learn more.

Apps & Technology

Evernote – My go-to note taking app. Syncs with most every tech device you own, and is pretty easy to use. Love how easy it is to categorize things, and you can even copy paper notes onto this bad boy. Essential for tracking many of my upcoming projects.

AllTrails – If you are an avid hiker, this app is a must have. I can’t tell you how many times this app saved me on questionable hikes, or given me access to hikes that I didn’t know about. In a class of its own.

Freedom – For those times you need to be immensely productive and the internet does nothing but distract you. This app will kick you off the internet for however long you so desire.

Deathclock – Another procrastination killer. Download this Chrome extension, and each time you open a new page you’ll see how many days you approximately have left to live. Morbid? Yes. Effective? Absolutely.

Photo Credits

Pixabay 

 

 

Continuing Education: The Complete Guide to Mastery

75

That’s my number.

No, not that number.

 

Pervert

75 is the number of continuing education classes, conferences, home studies, etc that I’ve completed since physical therapy school.

Though the courses are many, it was probably too much in a short period of time. When quantity is pursued, quality suffers. Sadly, I didn’t figure out how to get the most out of each class until the latter end of my career.

Two classes in particular stand out: Mobilisation of the Nervous System by the NOI Group, and ART lower extremity.

Yes, the content was great, but these classes stood out for a different reason. You see, instead of just doing a little bit of prep work, I kicked it up a notch. I extensively reviewed supportive material, took impeccable notes, and hit all the other essentials needed to effectively learn.

I was prepared, and because I was prepared I got so much more out of these classes than my typical fair.  The lessons learned in those courses stick with me to this day.

For the stuff you really want to learn, I’ll encourage you to do the same. Here is the way to get the most out of your continuing education. By the time you are done reading this post, you’ll understand why I now recommend a more focused learning approach and fewer courses.

Let’s see how to do it.

 

Continue reading “Continuing Education: The Complete Guide to Mastery”

The Post Wonderful Time of the Year: Top Posts of 2013

The Best…Around

Time is fun when you are having flies. It seems like just yesterday that I started up this blog, and I am excited and humbled by the response I have gotten.

Hearing praise from my audience keeps me hungry to learn and educate more.

I am always curious to see which pages you enjoyed, and which were not so enjoyable; as it helps me tailor my writing a little bit more.

And I’d have to say, I have a bunch of readers who like the nervous system 🙂

Like porn for my readers.
Yeah, it’s pretty cool

I am not sure what the next year will bring in terms of content, as I think the first year anyone starts a blog it is more about the writing process and finding your voice.

Regardless of what is written, I hope to spread information that I think will benefit those of you who read my stuff. The more I can help you, the better off all our patients and clients will be.

So without further ado, let’s review which posts were the top dogs for this year (and some of my favorite pics of course).

10.  Lessons from a Student: The Interaction

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Actually, I have found I now have more success setting up my interactions like this.

This was probably one of my favorite posts to write this year, as I think this area is sooooooo underdiscussed. Expect to be hearing more on patient interaction from me in the future.

9) Clinical Neurodynamics Chapter 1: General Neurodynamics

Any post with Predator in it has been shown to increase T levels by 300%
Any post with Predator in it has been shown to increase T levels by 300%

Shacklock was an excellent technical read. In this post we lay out some nervous system basics, and why we call neurodynamics what we call it.

8) Course Notes: Graded Motor Imagery

Drawing skillz unparalleled.
Drawing skillz unparalleled.

It seems like I took this course forever ago, but reviewing this post reminded me why I love the NOI group so much. I feel as though their message is one you cannot get enough of.

As for GMI itself, I find that it is great for people who most every movement hurts, as well as an educational piece. From a PRI perspective, it is also useful. I have had patients imagine contracting their glute max and go neutral. Crazy stuff.

7) Explain Pain Section 6: Management Essentials

I totally recall how awesome this post was...Just see the movie
I totally recall how awesome this post was…Just see the movie

Hopefully after following this blog you have a better understanding of pain than the average bear, so here are some basic ways we can manage the pain experience.

6) The Sensitive Nervous System Chapter III: Pain Mechanisms and Peripheral Sensitivity

When I see someone stub their toe, I'm not thinking a stubbed toe.
When I see someone stub their toe, I’m not thinking a stubbed toe.

One of my very first posts, so maybe a Cupples classic?

Anyway, here we explore in great detail what nociception and peripheral neuropathic pain are; and why you should go to the emergency room when you stub your toe 🙂

5) Course Notes: PRI Myokinematic Restoration

Because why not?
Because why not?

I am very glad this post got many views, as I feel the message these guys send is some of the best on the market. Here is PRI 101, and expect to hear a lot more about their work this upcoming year.

4) The Sensitive Nervous System Chapter VIII: Palpation and Orientation of the Peripheral Nervous System

There was a time in which I didn't post funny pics...Besides, who doesn't like Led Zeppelin?
There was a time in which I didn’t post funny pics…Besides, who doesn’t like Led Zeppelin?

One underrated way to assess the nervous system is via palpation. You can get a lot of interesting responses on people. Here we learn how.

3) Clinical Neurodynamics Chapter 2: Specific Neurodynamics

I really feel like my artistic endeavors became their own once I started drawing in color.
I really feel like my artistic endeavors became their own once I started drawing in color.

In this post we learn a lot of local nervous system tidbits, and more information on my future Therapeutic Microsoft Paint Course 🙂

2) Course Notes: Mobilisation of the Nervous System

That my writing pace has slowed down.
That my writing pace has slowed down.

Such a great class. Here we see updates to the science behind “The Sensitive Nervous System”, as well as some neat tweaks to our neurodynamic testing. My favorite pieces were on the immune system and genetics.

1) Explain Pain Section 1: Intro to Pain

Because what's a post on my site without a Bane reference?
Because what’s a post on my site without a Bane reference?

This section could be a manifesto for this blog. Learning and understanding pain has been one of the biggest game changers for me as a clinician and writer.

Simply put, if you work with people in pain, this section is a must-read.

C’est Fini

So there you have it. Which posts were your favorite? Which would you like to see more/less of? Comment below and let a brother know.

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Course Notes: FMS Level 2

Mobility, Stability, and the Like

I recently attended the FMS Level 2 course after rocking the home study. In my quest to take every con ed course known to man, I got into the functional movement people because the idea of improving movement over isolation exercise interests me. I find the way they build up to the patterns very logical, namely because they liberally use PNF and developmental principles; and they do so quite eloquently.

The whole weekend was kinda like this.
The whole weekend was kinda like this.

But really, I wanted to go to this class so I could meet and learn from Gray Cook. And his segments did not disappoint. While I may not agree with everything he says, he is a very brilliant man and knows movement.

The only disappointment I have to say about this course was that I did not get enough Gray and Lee. I would say I probably saw them teach 30% of the time, with another FMS instructor just running us through their algorithms. I am sorry, but if you are going to advertise Gray Cook and Lee Burton as the instructors, then I want Gray and Lee instructing me!

A lot of these exercises were review for me, but there were definitely some tweaks that I liked a great deal. I think if you are new to more motor control-based exercises, this course is great for you. Just make sure you are taking it from Gray and/or Lee.

Mad props to this fellow.
Mad props to this fellow.

Why Screen?

The FMS is predominately used to manage risk and prioritize exercise selection. They look at fundamental movement patterns to rule in/out asymmetries and dysfunctions, which ultimately allow someone to safely train in the weight room.  If you are unfamiliar with the FMS, check out this previous post from my review of the Movement Book

Lee Burton mentioned that his goal is to look for 0’s and 1’s; once we get to 2’s we’re good to go. This number ensures we have movement compentency as opposed to excellence, which is a requisite to loading these movements.

One thing I will say positively about this group is that they are all for doing and testing whatever you want, as long as you are consistent. But if you plan on doing the FMS, the research is done in the same manner taught in the home study course and the Movement Book.

Prioritizing Correctives

Within the FMS model, we choose corrective exercise based on a particular hierarchy. Mobility impairments are attacked first via the active straight leg raise (ASLR) and shoulder mobility (SM) tests. From those two screens, ASLR is first corrected. We go after this part first because developmentally we have leg control before we do arm control. Moreover, ASLR is purely sagittal plane, versus the triplanar shoulder screen.

Once we get good mobility, we then work on developing improved motor control via rotary stability (RS) and trunk stability pushup (TSP); done in that order.

Once these areas are squared away, we go after functional patterns. We first hit the inline lunge (ILL), then the hurdle step (HS), then the deep squat (DS).

Followed by this
Followed by this

In-depth Screening

The FMS actually started incorporating more movements to look at once you get into level 2, which eerily look like the SFMA. Likely because it is the SFMA 🙂 Here is where to screen next once you get past the basics.

  • ASLR –> Toe Touch –> crocodile breathing
  • SM –> Cervical ROM–> Impingement testing –> AC impingement testing –> Seated T-spine rotation –> Grip screen –> Crocodile breathing
  • RS –> Spinal flexion clearing –> Crocodile breathing –> Upper body rolling –> Lower body rolling
  • TSP –> Spinal extension clearing –> Crocodile breathing
  • ILL –> Ankle mobility (goal is 40 degrees in half-kneeling)
  • HS –> Ankle mobility
  • DS –> Ankle mobility –> Toe Touch

Let’s Correct

The corrections for each movement progress from mobility, to static motor control, to dynamic motor control, and finally strength. Here were some of my favorite correctives for each screen (Many videos courtesy of the IFAST folks).

ASLR

Mobility work goes after the hip flexors and performing leg-lowering patterns.

Static motor control involves working in half-kneeling, and dynamic involves patterning from double leg to single leg deadlifts. One of my favorite correctives was utilizing RNT to facilitate the lats during deadlifts.

I also liked the way he patterned the deadlift by using a squat to get into the position

Once you get the deadlifts down, load-up for strength

SM

Mobility predominately went after the t-spine via various rib-rolls and such:

Motor control involved deadlifts again, as well as various drills that involve shoulder packing:

We can progress these drill dynamically to armbars, get-ups, pushups, working toward a press in the horizontal and vertical planes. And of course, don’t forget the beastly real row:

RS

The correctives usually build on from previous one’s the further you go in the screen. Mobility involves rib rolls and ASLR derivatives. Eventually you work toward quadruped and bird-dog activities.

Once you get past the easy stuff, we go into rolling a la SFMA, with the hard-roll being next in line (Thank you Perry Nickelston):

We can then progress to single leg deadlifts, presses, and pulls.

TSP

Mobility work involves hip flexors and half-kneeling. We go after motor control via planks, mountain climbers, and quadrupedal activities. From here, we just go into pushup progressions; culminating into various presses.

ILL

The big mobility work goes after hip flexors and calves. With the famous brettzel stretches being incorporated here:

Motor control exercises go from half-kneeling building up to lunge variations. Eventually, we will load these patterns.

HS

Mobility work builds further onto previous exercises; leg lowering, ASLR, dorsiflexion. We also go into stride stretches, which are basically mobilizations in a hurdle-step position.

Motor control goes from half-kneeling to single-leg chops and lifts, all the way to single leg deadlifts. The ultimate strength exercise for this pattern is step-ups

DS

Mobility work goes after ankle dorsiflexion, hip flexors, and any SM corrections.

Motor control involves working in tall-kneeling (foam roller behind to cue upright posture) and progressing from deadlifts to squats

Eventually we work toward performing an overhead squat.

Other random exercises

I also liked how Gray added some nice tweaks to the Turkish get-up which you will see below:

“Gray”te Quotes…Get it? It’s funny because I combined Gray Cook with the word great…just read on

  • “Tightness and fatigue feel the same way.”
  • “If I could pick four exercises to do, they would be chops, lifts, deadlifts, and Turkish Get-ups.”
  • “Your people with total hips and total knees should get up from the floor.”
  • “Stabilizers have to be fast, not strong.”
  • “Everyone develops differently.” (Haha DNS)
  • “3 degrees of extra mobility leads to 300 degrees of increased proprioception.”
  • “The best entertainment you can get is results.”
  • “There’s a difference between good and bad and good and can’t.”
  • “We’re not laying down new motor programs, we’re getting old ones back.” (This was from Lee)
  • “First step in correctives is to remove the negatives.” (Also from Lee)
  • “Any wasted rep is costing you success.”
Please remove the negatives.
Please remove the negatives.

 

Chapter 15: In Conclusion

This is a chapter 15 summary of the book “Movement” by Gray Cook.

The Goal

The goal of movement retraining is to create authentic unconscious movement at acceptable levels. We can develop many methods to achieve our goals, but working under sound principles is paramount. Some of the principles Gray advocates include:

  • Focusing on how we move.
  • Look to movement to validate or refute your intervention.
  • Movement is always honest.
Of course I did my corrective exercise, I swear.
Of course I did my corrective exercise, I swear.

When designing a movement program, we must operate under the following guidelines:

  • Separate pain from dysfunctional movement patterns.
  • Starting point for movement learning is a reproducible movement baseline.
  • Biomechanical and physiological evaluation do not provide a complete risk screening or diagnostic tool for comprehensive movement pattern understanding.
  • Our biomechanical and physiological knowledge surpass what we know about fundamental movement patterns.
  • Movement learning and relearning follows a hierarchy fundamental to the development of perception and behavior.
  • Corrective exercise should not be rehearsed outputs. Instead, it should be challenging opportunities to manage mistakes on a functional level near the edge of ability.
  • Perception drives movement behavior and movement behavior modulates perception.
  • We should not put fitness on movement dysfunction.
  • We must develop performance and skill considering each tier in the natural progression of movement development and specialization.
  • Corrective exercise dosage works close to baseline at the edge of ability with a clear goal.
  • The routine practice of self-limiting exercises can maintain the quality of our movement perceptions and behaviors and preserve our unique adaptability that modern conveniences erode.
  • Some things cannot be fixed, but change what you can.
  • The brain that learns function can learn dysfunction.
  • Be safe, be satisfied, and play.
I can always tell when movement is sassified.
And I can always tell when movement is sassified.

Chapter 14: Advanced Corrective Strategies

This is a chapter 14 summary of the book “Movement” by Gray Cook.

Inputs

Corrective exercise is focused on providing input to the nervous system.  We are allowing the patients and clients to experience the actual predicament that lies beneath the surface of their movement pattern problem. It is okay for mistakes to be made, for these errors help accelerate motor learning. Minimal cueing should be utilized, as we want to patient to let them feel the enriching sensory experience.

Mistakes are good...I wouldn't be here without them.
Mistakes are good…I wouldn’t be here without them.

Motor Program Retraining

There are several different methods in which we can achieve a desired motor output.

1)      Reverse patterning – Performing a movement from the opposite direction.

2)      Reactive neuromuscular training – Exaggerating mistakes so the patient/client overcorrects. Use oscillations first, followed by steady resistance.

3)      Conscious Loading – Using load to hit the reset button for sequence and timing.

4)      Resisted exercise – Makes patterns more stable and durable.

When you can deadlift that much, most anything is stable and durable.

Movement Chapter 13: Movement Pattern Corrections

This is a chapter 13 summary of the book “Movement” by Gray Cook.

Back to the Basics

Mobility deficits ought to be the first impairment corrected. Optimizing mobility creates potential for new sensory input and motor adaptation, but does not guarantee quality movement. This is where stability training comes in. In order for the brain to create stability in a region, the following ought to be present:

  • Structural stability: Pain-free structures without significant damage, deficiency, or deformity.
  • Sensory integrity: Uncompromised reception/integration of sensory input.
  • Motor integrity: Uncompromised activation/reinforcement of motor output.
  • Freedom of movement:  Perform in functional range and achieve end-range.
FREEDOM!!!! Of movement. And if the Road Warrior says we need to move free I listen.

Getting Mobility

There are 3 ways to gain mobility:

1)      Passively: Self-static stretching with good breathing; manual passive mobilization.

2)      Actively: Dynamic stretching, PNF.

3)      Assistive: Helping with quality or quantity, aquatics, resistance.

Getting Stability

In order to own our new mobility, we use various stability progressions to cement the new patterns. There are three tiers in which stability is trained:

1)      Fundamental stability – Basic motor control, often in early postures such as supine, prone, or rolling.

2)      Static stability – done when rolling is okay but stability is compromised in more advanced postures.

3)      Dynamic stability – Advanced movement.

We progress in these stability frames from easy to further difficult challenges.

Assisted → active → reactive-facilitation/perturbations

I would black my face out to if someone was having me do this exercise.
I would black my face out too if someone was having me do this exercise.

Since stability is a subconscious process, we utilize postures that can challenge this ability while achieving desired motor behavior. We can also group the various postural progressions into 3 categories:

1)      Fundamental – Supine, prone, rolling (requires unrestricted mobility).

2)      Transitional – Postures between supine and standing such as prone on elbows, quadruped, sitting, kneeling, half-kneeling.

3)      Functional: Standing variations to include symmetrical and asymmetrical stance, single leg stance.

The only legit way to practice single leg stance.

Movement Chapter 12: Building the Corrective Framework

This is a chapter 12 summary of the book “Movement” by Gray Cook.

A Whole Lotta P

When we build our corrective framework, we must take into account the 6 P’s:

1)      Pain – Is there pain with movement? Staying away from pain improves motor control.

2)      Purpose – What movement pattern are we targeting with corrective exercise and what problem are we addressing (i.e. mobility, stability, dynamic motor control)?

3)      Posture – Which moderately challenging posture is the best starting point for corrective exercise that allows for reflexive activity?

4)      Position – Which ones demonstration mobility/stability problems and compensatory behaviors?

5)      Pattern – How is the dysfunctional movement pattern affected by corrective exercise?

6)      Plan – How can you design a plan based on findings?

The goal when designing the correction is to stay in the middle ground of the autonomic nervous system while providing a rich sensory experience.  Movement pattern dysfunction is a behavior that needs to be addressed and changed.

Movement Chapter 11: Developing Corrective Strategies

This is a chapter 11 summary of the book “Movement” by Gray Cook.

Autonomics

All exercise affects tone and tension. This influence is the basis for movement. The autonomic nervous system determines movement as threatening or not, which determines requisite tone. It is important to nudge movement towards further nonthreatening yet advanced stimuli.

 

FMS Corrections

Proceeding to correct under FMS protocol is determined by screen results and changed via exercise.  We first correct mobility, next reinforce stability, then retrain movement patterns. Stability training in particular follows a sequence:

1)      Challenge posture and position.

2)      Build mid-range strength.

3)      Develop end-range stability.

Movement patterns are corrected in the following hierarchy:

ASLR & Shoulder mobility → rotary stability → pushup → Inline lunge → hurdle step → Deep squat

 

SFMA Corrections

The SFMA corrective pathway is nonlinear unlike the FMS. The breakouts will tell you which direction to go to restore optimal movement.

The options are also increased. Often to gain mobility, you would utilize various manual therapies or other modalities. To alter stability, taping, orthotics, braces, or anything else to increase motor control may be utilized.

Movement patterns are corrected in the following hierarchy:

Cervical spine → Shoulder multi-segmental flexion & extension→ Multisegmental rotation single leg stance → Squat

Depending on how movements present, certain therapies are utilized:

DN – manual therapy and corrective exercise.

DP – Manual therapy and modalities.

FP – Modalities and manual therapy.

FN – General exercise.

Modalities? No FN way...See what I did there??? Ah hell with it.
Modalities? No FN way…See what I did there??? Ah hell with it.

Exercise Categories

There are several exercise types that can be utilized depending on one’s goal:

  • Functional: Purposeful exercise that displays carryover to other activities. Can be general (for movement patterns) or specific (for certain skills). These generally enhance physical capacity.
  • Corrective: To create a functional base, normalize tone, and allow movement freedom.
  • Conditioning: Create positive neurophysiological adaptations in structural integrity/performance over periods longer than a single exercise series.
  • Movement prep: Work on patterns needed for activity.
  • Skill training: For specific skills.

Movement Chapter 10: Understanding Corrective Strategies

This is a chapter 10 summary of the book “Movement” by Gray Cook.

Mistakes, I’ve Made a Few

When we are talking corrective exercise design, people often make 4 mistakes:

1)      Protocol approach: Exercise based on category.

Problem – 1 size fits all.

2)      Basic kinesiology: Target prime movers and some stabilizers.

Problem – fails on timing, motor control, stability, and movement.

3)      Appearance of functional approach – Use bands and resistance during functional training.

Problem – If the pattern is poor, adding challenges to it can increase compensation. There is also no pre-post testing.

4)      Prehabilitation approach – Prepackaged rehab exercises into conditioning programs as preventative measures to reduce injury risk.

Problem – Design is based on injuries common to particular activities as opposed to movement risk factors.

Several, so it seems.

There are also certain mistakes that are often made when utilizing the FMS and SFMA:

1)      Converting movement dysfunction into singular anatomical problems.

2)      Obsessing over perfection in each test instead of identifying the most significant limitation/asymmetry.

3)      Linking corrective solutions to movement problems prematurely.

The overarching rule is to address these movement deficiencies first, as we do not want to put strength or fitness on top of dysfunctional movement.

 

The Performance Pyramid

When designing an exercise program, we look for three areas to improve performance: Movement, performance, and skill.

performance pyr

It is important that program design is based on the individual’s needs and has these qualities in a hierarchal fashion. For example, if one performs excellent on functional performance capabilities but has poor foundational movement, injury risk may increase.

 

Program Design

When implementing corrective exercise, it is important to provide the correct stimulus amount. We want the individual challenged, but not struggling for dear life.

  • Too easy – >30 reps with good quality.
  • Challenging, but possible – 8-15 reps with good quality and no stress breathing. There is a decline in quality secondary to fatigue towards the end of rep ranges.
  • Too difficult – Sloppy from the beginning and only worsens.

Rarely does increasing difficulty equate to increasing resistance. Oftentimes you may advance the exercise position, decrease the base of support, or add more movement complexity.

You may have to remove some activities that feed into dysfunction from one’s current programming, lest you wish to not change the movement pattern. Often how quickly one changes his or her ability to move depends on how diligent one is with corrective exercise.

Realize that corrective exercise should only be supplemental and temporary to what one is doing. It is supposed to be corrective in nature, not preventative.  Moreover, movement scores can decrease with hard training, so continual reassessment is important.

I do active leg lowering and wall ankle dorsiflexion while I'm taking NO Xplode bro.
I do active leg lowering and wall ankle dorsiflexion while I’m taking NO Xplode bro.

The corrective exercise pathway should proceed as follows:

1)      Exercise selection is driven by screen and assessment.

2)      A thought out framework gives you the best possible choices.

3)      Retest, note positive or negative changes, and then use results to modify next session.

4)      Reassess once an obvious change is noted to see what the next priority is.

Ain’t no need to question the Authority